Royal helps nation lead way in prenatal care, 100 years on

MEN are terrible wimps, according to Stephen Steigrad, who worked at the Royal Hospital for Women for about 45 years. He retired as the hospital's director of reproductive medicine in July.

''I enjoyed working with women,'' Dr Steigrad said. ''I found men very boring, they're terrible wimps. Women are vastly more stoic and it's amazing any woman will go through labour, come back and do it all again.''

Dr Steigrad shared his reflections as December marked 100 years of prenatal care at the Royal Hospital for Women in Randwick. It was one of three hospitals worldwide to have pioneered prenatal care, and is the only one of the three to have survived. It is the longest continuous provider of antenatal care in the world.

''The establishment of the prenatal clinic 100 years ago was very important,'' Dr Steigrad said. ''It was quite innovative. Prior to that a woman would turn up, be told if she was pregnant or not and if she was, to come back when she was in labour.

''The prenatal clinic was a new way of thinking because it meant looking after a woman and monitoring her progress during her pregnancy. It changed the way people looked at maternity care and certainly had an impact on the mortality rate of mothers and their babies.''

In 1910, Dr John Windeyer visited Edinburgh where he learnt about prenatal diagnosis and brought the concept back with him to the Royal Hospital for Women, according to The Royal, a book on the hospital's history.

He helped establish the prenatal clinic which officially opened in December 1912. In its early days the clinic focused on identifying urinary tract infections and heart disease, two significant causes of maternal death.

Australia leads the world in prenatal care, Dr Steigrad said, with an increasing number of once potentially fatal maternal conditions being diagnosed and treated during pregnancy.

''The things we do now were considered impossible when I started out in medicine,'' Dr Steigrad said.

''I remember the day one of my colleagues, the late Coll Fisher, carried out the first fetoscopy, where you make a small incision in the abdomen and push a very thin fibre-optic instrument into the uterus so you can actually see the foetus. Everybody was absolutely flabbergasted. Innovations like that were why I stayed in the job so long. I just had so much fun.''

Other breakthroughs at the Royal included the establishment of the ultrasound department in 1962 - the second in the world.

Last year, the hospital and the University of NSW established an Australian Centre for Perinatal Science which has seen new developments in antenatal care.

''Back when I started in medicine people accepted the fact mothers and babies died during pregnancy,'' Dr Steigrad said.

''But around the turn of the 20th century there was [a] change in thinking that it was not normal, something had to be done and that's what started [the] concept of prenatal care.''